Abstract:
The authors have investigated the effect of very early irrigation
of the cerebrospinal fluid (CSF) space in the haemorrhage rat model
of vasospasm. Fifteen rats had basilar cistern irrigation with physiological
saline for 3 hours after subarachnoid haemorrhage (SAH),
and fifteen control rats had subarachnoid haemorrhage without irrigation
of clot.
The changes in basilar arteries diameters were determined by
angiograms obtained from the rats. The post haemorrhage anglograms
showed significant basilar artery spasm in both groups
(P ~< 0.0005, t-test). However in the last angiogram the basilar artery
diameter was found to have the same value measured before subarachnoid
haemorrhage in the irrigation group whereas no obvious
change was observed in the control group. In the irrigation group
the mean diameter of the basilar artery in the last angiogram was
0.412ram. (0.30ram to 0.50mm). None of the animals, treated by
cisternal irrigation, showed angiographic vasospasm while the latter
group did (P ~< 0.0005). Animals treated with physiological saline
irrigation had a median clot grade of 0.40 (range grade 0 to 2);
control rats had a median grade 2.86 (range grade 1 to 4, P < 0.001,
Mann-Withney U test), on the brain stem, indicating significant
reduction of clot by lavage.
In conclusion, performance of experimental physiological saline
irrigation at a very early time after subarachnoid haemorrhage prevents
the arteriographic and morphological changes of both acute
and late vasospasms.
